The Cheat is formed at Parsons, West Virginia, by the confluence of the Shavers Fork and Black Fork. The Black Fork is fed by the Blackwater River and by the Dry, Glady, and Laurel forks — these are traditionally referred to as the five Forks of Cheat. From Parsons the Cheat River flows generally northward through Tucker and Preston counties, past the towns of Rowlesburg and Albright. It then flows through an impressive gorge — Cheat Canyon — northeastwardly from Albright, collecting Big Sandy Creek before entering Monongalia County, where a hydro-electric dam just south of the Pennsylvania border causes it to widen as the Cheat Lake reservoir. It then flows for a short distance through southwestern Fayette County, Pennsylvania, before joining the Monongahela River at Point Marion, Pennsylvania. Upstream of its dam, the Cheat is one of the largest undammed watersheds in the eastern United States.
Cheat Mountain, a high and rugged ridge, runs about 50 miles (80 km) southward from its northernmost tip, just a few miles west of the confluence at Parsons.